Question: What is premenstrual dysphoric disorder and does it affect my risk of my developing an anxiety disorder?
Answer: Premenstrual dysphoric disorder is a disorder related to the menstrual cycle. It is a more severe set of symptoms or severity of symptoms than what we commonly think of as premenstrual syndrome, which really effects about half women.
Premenstrual dysphoric disorder is much less common. It occurs during most of the menstrual cycles during the year. And it occurs specifically in the week prior to menstruation and for the first three days of the menstrual cycle.
The symptoms have to disappear during the rest of the cycle in order to be considered premenstrual dysphoric disorder. The symptoms need to include both a mood symptom, and that can be anything from irritability to intense anger, depressed mood or feeling down, rejection sensitivity or tearfulness or real agitation anxiety.
The other symptoms that can be considered criteria for premenstrual dysphoric disorder include physical symptoms like bloating, headache, appetite change or craving, physical muscle joint pain, gastrointestinal symptoms. And also more minor mood symptoms like irritability, edginess, fatigue, decreased concentration.
So if one has about five or more of those symptoms for each subsequent menstrual cycle for most of the year, then one is considered to have PMDD.
Does it increase the risk for anxiety disorder? Well, not really. It does increase the risk for depression, especially in menopause and it can be confused or, well, let me put it this way: anxiety disorders tend to worsen premenstrually as well.
So while PMDD does not specially increase risk, anxiety disorders that may be preexisting need to be differentiated from premenstrual dysphoric disorder because they, too, can worsen premenstrually. Similarly, depression does as well tend to worsen premenstrually.